A retrospective study of dropout rates from a community mental health centre and associated factors.

Abstract

To ascertain if decentralization of mental health services, making them more accessible to the public, would be reflected in a decrease in the dropout rate, a comparison was made between dropout rates just prior to and immediately following decentralization. This involved examining 1350 closed files representing cases seen during a three-year period after decentralization and comparing the findings with those of a previous study of files of 588 cases seen during a year before decentralization. The dropout rate decreased from 46% to 43%; while statistically significant, this change was too small to be of any practical importance. However, analysis of demographic and clinical variables in the post-decentralization sample proved most interesting. On the whole, it confirmed the findings from previous investigations, i.e. dropouts tended to be younger, less well-educated, of low socioeconomic status (SES), and were most commonly diagnosed as having a personality disorder. Although some therapists had a comparatively large proportion of dropouts, this discrepancy may reflect the distribution of difficult cases rather than the effectiveness of the therapists.